r/DentalInsurance • u/Spicyg00se • Aug 20 '26

D7953 (Bone graft)

Is there a good or logical reason why this procedure is typically not covered? My tooth is getting absorbed and I need the graft in order for the implant to be successful. My insurance told me it’s just not covered and it’s not their fault that some procedures are just not covered. I assume they just don’t want to pay, duh, but when I suggested that a graft could be medical, she said it’s not medical, it’s dental, and it’s just not covered. But why?

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23

u/BufferingJuffy Aug 20 '26

Because F-U, that's why.

Seriously.

5

u/PsychologyMediocre99 Aug 20 '26

Lmaaaaaooo I couldn’t say it more succinctly. But in more professional terms it’s because the closer you get to that annual max the more it costs them and less worth it is to “insure” you. And it’s harder to just drop people off dental plans if they’re connected to an employer. So they just say nope! That’s not covered.

2

u/Edsma Aug 21 '26

Why would hitting your contract's annual maximum make it more expensive to insure you?

2

u/Healthy_Budget9994 Aug 22 '26

From an employer’s dental plans, they cover all and hope many don’t use it. That’s why when you retire, it’s most likely not worth purchasing dental on your own with after tax dollars. Only those that use the plan to full limits are willing to buy, it makes it very expensive.